| NPI | 1730342023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: MO 2010013499) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2010013499) |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2026-08-27 |